Critical appraisal:Miros M, Kerlin P, Walker N 1991

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Critical Appraisal

Article being appraised

Miros M, Kerlin P, Walker N. Only patients with dysplasia progress to adenocarcinoma in Barrett's oesophagus. Gut 1991 Dec;32(12):1441-6 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/1773946.


Applicable clinical question

Key Facts

Study Design

cohort study

Number of Patients:

81


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
High risk of bias Comments: Outcome of prospective cohort of patients who did and didn't enter a surveillance programme. Good follow up of both groups, although no comparative data in difference in charachteristics and outcome between two groups. Decriptive data regarding risk factors for developing adenocarcinoma in surveillance (only occured in those with dysplasia). Recommendation of timing re follow up endoscopy but no data to support.

Risk of bias assessment: cohort study

Subject selection
"New technology" group
No response
Comparison group
No response
Comparability of groups on demographic characteristics and clinical features
No response
Measurement of outcomes
Outcome measures blind to technology used
No response
Same method of measurement used across comparison groups
No response
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
No response
Size of effect
1 Reason for decision: All patients without dysplasia didn't developed oesophageal adenocarcinoma. All oesophageal adenocarcinomas developed in those with preceeding dysplaisa. The The incidence of adenocarcinoma in Barrett's oesophagus in this study was one case per 96 patient years (61 times (95% confidence limits 12-176) the age adjusted incidence of oesophageal cancer in Australia.
Relevance of evidence
1 Additional comments: Study looks at development of patient relevant outcome (cancer).
Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Bradley Kendall MBBS, FRACP


Jutta's tick icon.png This appraisal has been completed.


Article
Miros M, Kerlin P, Walker N. Only patients with dysplasia progress to adenocarcinoma in Barrett's oesophagus. Gut 1991 Dec;32(12):1441-6 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/1773946.
Assigned to
User:Brad.kendall
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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